Dorsomedial prefrontal cortex repetitive transcranial magnetic stimulation treatment of posttraumatic stress disorder in eating disorders: An open‐label case series

• Published in: The International journal of eating disorders Vol. 50; no. 10; pp. 1231 - 1234
• Main Authors: Woodside, D. Blake, Colton, Patricia, Lam, Eileen, Dunlop, Katharine, Rzeszutek, Julia, Downar, Jonathan
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-10-2017
• Subjects: Adult; Anorexia; Brain; Bulimia; Comorbidity; Eating disorders; Feeding and Eating Disorders - diagnostic imaging; Female; Humans; Male; Post traumatic stress disorder; Prefrontal Cortex - anatomy & histology; PTSD; rTMS; Stress Disorders, Post-Traumatic - diagnostic imaging; Stress Disorders, Post-Traumatic - therapy; Transcranial magnetic stimulation; Transcranial Magnetic Stimulation - methods; treatment; Treatment Outcome; PTSD; treatment; rTMS
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/eat.22764

Posttraumatic stress disorder (PTSD) is a common comorbid condition in anorexia nervosa (AN) and bulimia nervosa (BN), and may be associated with reduced response to treatment. We report on a case series employing repetitive transcranial magnetic stimulation (rTMS) with a novel target, the dorsomedial prefrontal cortex (DMPFC). Fourteen subjects with eating disorders and comorbid PTSD received 20–30 neuronavigated DMPFC–rTMS treatments on an open‐label basis. PTSD symptoms were assessed pretreatment and posttreatment with the PTSD checklist‐Civilian (PCL‐C) and the Difficulties in Emotional Regulation Scale (DERS). PCL‐C scores were reduced by 51.99% ± 27.24% overall, from a mean of 54.29 ± 19.34 pretreatment to 24.86 ± 17.43 posttreatment (p < .001). Of the 14, 8 showed an improvement of >50%. DERS scores improved by 36.02% ± 24.24% overall, from 140.00 ± 22.09 at pretreatment to 89.29 ± 38.31 at posttreatment (p < .001). OF the 14 subjects, 5 achieved >50% improvement. These data may suggest that DMPFC–rTMS could be helpful in the treatment of PTSD in some ED patients.